Friday, 30 May 2014

Do different interferons preparations affect cognition differently?

What will the impact of long-acting pegylated interferon-beta have on brain atrophy? #MSblog #MSResearch

"Could there really be a difference between the interferon preparations and cognition? The study below suggests interferon-beta-1a has a positive impact on cognition, but not interferon-beta-1b. This is a very small study and will need to be reproduced. However, there seems to be a difference between low frequency interferon (Avonex) and the high frequency interferon preparations (Rebif and Betaferon/Betaseron) when it comes to an impact on brain atrophy. Avonex seems to have a small but consistent impact on slowing brain atrophy compared to the other innovator compounds. Why? It may be that intermittent stimulation of the type 1 interferon receptor is neuroprotective, whilst continuous stimulation of the receptor is not. Continuous stimulation with high frequency interferon internalises receptors and may change the biology of certain cell types within the central nervous system. It is surprising that Biogen-Idec, who have known about the differential impact of the different interferon preparation on brain atrophy went ahead and developed a long-acting pegylated interferon. I would be interested to see what effect pegylated-interferon, which will all most certainly stimulates the receptor continuously and reduce expression on the cell surface, will have on brain atrophy. I would not be surprised if it behaves in the same way as Rebif and Betaferon/Betaseron."

 
Epub: Mokhber N et al. Cognitive dysfunction in patients with multiple sclerosis treated with different types of interferon beta: A randomized clinical trial.J Neurol Sci. 2014 Feb 4. pii: S0022-510X(14)00062-8. doi: 10.1016/j.jns.2014.01.038. [Epub ahead of print]

BACKGROUND: MS is a chronic autoimmune disease that can deteriorate cognitive function in at least 50% of MSers even in the early stages.

OBJECTIVE: We conducted a three-arm parallel study with balanced randomization to evaluate the effect of various disease-modifying therapies (DMTs) on cognitive function in MS.

METHODS: Ninety newly diagnosed, definite MS subjects referred to Ghaem Medical Center, Mashhad, Iran, were enrolled into this study between 2006 and 2009. They were randomly categorized into three DMT groups; Avonex, Rebif and Betaferon. Cognition status was assessed in MSers at baseline and 12 months after treatment with DMTs using the 5 tests of the Brief Repeatable Battery of Neuropsychological Tests (BRB-N).

RESULTS: The Symbol Digit Modalities Test scores improved in all groups at 12 month vs. baseline (Avonex: 34.50 vs. 38.95, p=0.011; Rebif: 35.30 vs. 40.13, p=0.001; Betaferon: 26.18 vs. 29.32, p=0.029). The Selective Reminding Test (SRT)-Total, the 10/36-Delay, and the Paced Auditory Serial Addition Test-Easy were improved in Avonex and Rebif but not in Betaferon group. The SRT-Delay and Word List Generation were improved only in the Avonex group. There was no significant difference in other components of the BRB-N among these three treatment groups.

CONCLUSIONS: Different types of DMTs may improve some aspects of cognitive function in patients with MS. Treatment with Avonex and Rebif (Interferon beta-1a preparations) were more helpful in resolving the cognitive impairments in MSers compared to Betaferon (Interferon beta-1b) as investigated in this study.

CoI: multiple

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